Factors that may contribute to sexual dysfunction in a male with COPD:
(1) breathlessness
(2) easy fatigability during exertion
(3) depression and/or anxiety
(4) medications that may cause ED
(5) concurrent heart failure
(6) malnutrition
(7) smoking, hypertension, hyperlipidemia and other risk factors for atherosclerosis
(8) reduced libido
These issues can be addressed during pulmonary rehabilitation:
(1) discontinue smoking
(2) reduce the dose or change medications associated with ED
(3) treat depression and anxiety using drugs not associated with ED
(4) treat hypertension and hyperlipidemia using drugs not associated with ED
(5) improve nutrition
(6) begin an exercise program
(7) provide supplemental oxygen if indicated
(8) consider use of a PDE5 inhibitor